The gap between the number of people needing and accessing mental health care has led to the development of new types of mental health providers to help expand access to care. These providers, referred to as paraprofessionals, have typically at most a bachelor’s degree and treat mild and moderate depression and anxiety. However, because the novelty of these roles in the Unites States, little is known about organizational and employee barriers to uptake and implementation. Further, little is known about US patient perspectives on having a paraprofessional mental health provider. The proposed research explores behavioral health employer, behavioral health employee, and patient perspectives on two new paraprofessional roles being deployed in Washington State – the mental health Community Health Worker and the Behavioral Health Support Specialist – to help identify key barriers and facilitators to implementation of these roles.
Targeted Condition: Anxiety
Self-directed mindfulness in medically hospitalized patients: a pragmatic trial
Consultation-liaison psychiatrists are often asked to manage mood and anxiety symptoms experienced by patients admitted to medical and surgical floors of the hospital. This study aims to determine the feasibility and effectiveness of a self-directed mindfulness intervention as an adjunctive treatment for improving mood, anxiety, and perceived stress in medically hospitalized patients. Participants, consisting of patients evaluated by the consultation-liaison psychiatry service, will be randomized to an adjunctive mindfulness intervention group or a treatment-as-usual control group. Feasibility and acceptability of implementing a mindfulness intervention will be assessed. Group differences in the changes in symptom severity and psychotropic medication administration will be investigated.
Willow Study
The goal of this study is to understand the impact of stigma on mental health and recovery from trauma in different parts of the country.
Coach up the coaches: extending the reach of mental health professionals in sport settings
More than half of school-aged youth in the US play at least one organized sport, are similarly at-risk for mental health disorders as compared to their non-athlete peers, and face heightened barriers to seeking and sustaining mental health care. While coaches are not licensed mental healthcare providers, there is a robust evidence-base about laypeople (e.g., parents, teachers) effectively delivering brief interventions across population settings to help reduce psychological distress and increase the adoption of health behaviors. However, such brief interventions have not as-yet been adapted for the sport setting, or delivered by coaches.
The overarching goal of this project is to identify sport setting appropriate (very) brief interventions and adapt them for coach delivery in the sport setting. This will be accomplished by working in partnership with coaches, athletes, and licensed mental health care providers. We will use University of Washington’s First Approach Skills Training (FAST) training model (originally designed to train primary care clinicians in mental healthcare skills) to train a pilot cohort of coaches to deliver these interventions. This project is the starting point for a potentially transformative opportunity to extend the reach of mental healthcare professionals into the large and often underserved population of youth sport participants.
Evaluation and dissemination of the TRANSforming Families: Embracing Change with Teens Therapy Group
Transgender and gender diverse (TGD) adolescents experience 4-18 times higher rates of anxiety, 4-23 times higher rates of depression, 11-54 times higher rates of suicidal ideation, and 2-5 times higher rates of suicide attempts compared to their cisgender peers. Importantly, parents/guardians (i.e., caregivers) can have a significant impact on TGD adolescent mental health, with recent research suggesting that caregiver support and acceptance are associated with a 30-40% reduction in these mental health concerns.
Community-based support groups are common practice with TGD adolescents and families. However, group intervention programs that work specifically with caregivers are rare, and existing programs have not been formally evaluated. Therefore, the goal of this project is to evaluate TRANSforming Families: Embracing Change with Teens, a virtual, multi-family program that was developed by mental health providers in the Seattle Children’s Gender Clinic (SCGC), to understand its impact on caregiver support and acceptance and adolescent mental health. This partnership between SCGC mental health providers and researchers will represent one of the first formal evaluations of a group intervention program for caregivers of TGD adolescents, the results of which can inform future implementation and evaluation of this program in pediatric gender clinics across the United States.
State Implementation and Scaling-up of Evidence-based Practices (SISEP) Center
The State Implementation and Scaling-up of Evidence-based Practices (SISEP) Center is a national technical assistance center funded by the U.S. Department of Education’s Office of Special Education Programs. Through this subcontract, the UW SMART Center has a subcontract to develop a micro-credentialing program on implementation science (IS) for educators, and to develop and convene a national community of practice of educators focused on application of IS.
Optimizing mental health first-aid programming for sport coaches
Many sport organizations are increasingly vocal about the importance of athlete mental health. Helping organizations move beyond rhetoric to improved athlete wellbeing and safety requires evidence-based resources that are setting-appropriate and feasibly implemented.
This project will develop and obtain feasibility and acceptability data on “Time Out for Mental Health”—a mental health first aid training for sport coaches. This will be accomplished by adapting an existing evidence-based mental health first aid resource to the coach role and sport setting, working closely with a small group of coach partners. The team will focus on ensuring the training is considered useful and feasible by coaches who work in resource deprived school and community-settings given the heightened needs and challenges of youth in such settings, and will train coaches to deliver “Time Out for Mental Health”—to build organizational capacity. “Time Out for Mental Health”—has the potential to strengthen connections between sports organizations and school- and community-based mental health services for millions of adolescents as more than half of high school students play at least one organized school or community sport.
Discovery of conversational best practices in online mental health support
Millions of people lack access to mental health treatment due to barriers such as limited therapist availability, long wait times, high cost, and stigma. The COVID-19 pandemic has problematically increased demand for treatment while decreasing access. Because the internet is widely available, many people first turn to the internet for mental health support, giving rise to massive online psychotherapy, counseling and peer-to-peer support platforms such as Ginger and Talklife. However, not all conversations lead to improvement and may miss opportunities to help or even make things worse as platforms struggle to keep up with the increasing demands and lack methods for evaluating and promoting high-quality conversations.
This project seeks to improve the quality and scalability of online mental health support through real-time, evidence-based conversation feedback. We will leverage and analyze datasets of support interactions and associated outcomes across millions of individuals that use the partnering online mental health platforms at Ginger and Talklife. Our goal is to develop and pilot-test artificial intelligence methods that provide supporters on these platforms with practical just-in-time feedback and training. If successful, at least three benefits will follow our work. First, millions of help seekers using partnering mental health platforms Ginger and Talklife will receive higher quality responses through, for example, an expression of higher empathy. Second, those providing help will gain expertise faster and with less distress. Third, platforms and researchers will discover conversational best practices which can then be used to improve helper training and quality evaluation.
Behavioral Health Support Specialist (BHSS)
Our goals for this project include (1) designing a competency framework and learning objectives that define the role and scope of practice for a BHSS; (2) scaling the role for Washington state by creating processes for integrating the BHSS Clinical Training Program into existing four-year degree programs in the behavioral healthcare field; (3) partnering with Washington State higher education institutions to adopt the BHSS Clinical Training Program; (4) developing curricular resources to share with Washington State colleges and universities including an Educator’s Guide; (5) collaborating with government agencies, policy groups, and practicum partners to implement the BHSS role in employment settings. Department of Health approved programs deliver BHSS curriculum. For more information about approved education programs, visit the Department of Health (DOH) webpage, the Behavioral Health Support Specialist Workforce Development Project webpage, or contact:
Bill O’Connell, Ed.D.
Director, BHSS Workforce Development Project
Savannah Tidwell, BS
tidwell1@uw.edu
Program Manager, BHSS Workforce Development Project
The ATTEND study for Healthcare Workers and First Responders
Healthcare workers and first responders working during the COVID-19 pandemic have experienced increased exposure to suffering and loss; prolonged work hours; and increased personal risk. Although associated increases in psychiatric symptoms and occupational burnout are well documented, what aspects of the experiences are most strongly associated with negative outcomes over time – and what interventions are most likely to protect healthcare workers and first responders – are poorly understood.
The ATTEND study is designed to address the impact of occupational stress related to working during the COVID-19 pandemic on health care workers and first responders (police, fire, EMTs) through a national longitudinal survey paired with a local interventional clinical trial. The interventional clinical trial is designed to test the impact of treating sleep disruption with prazosin during or shortly after the period of exposure.
